scholarly journals Respiratory infections drive hepcidin-mediated blockade of iron absorption leading to iron deficiency anemia in African children

2019 ◽  
Vol 5 (3) ◽  
pp. eaav9020 ◽  
Author(s):  
Andrew M. Prentice ◽  
Amat Bah ◽  
Momodou W. Jallow ◽  
Amadou T. Jallow ◽  
Saikou Sanyang ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Respiratory Infections ◽  
Fecal Calprotectin ◽  
Deficiency Anemia ◽  
Low Grade ◽  
Reactive Protein ◽  
African Children ◽  
Low Grade Inflammation

Iron deficiency anemia (IDA) is the most prevalent nutritional condition worldwide. We studied the contribution of hepcidin-mediated iron blockade to IDA in African children. We measured hepcidin and hemoglobin weekly, and hematological, inflammatory, and iron biomarkers at baseline, 7 weeks, and 12 weeks in 407 anemic (hemoglobin < 11 g/dl), otherwise healthy Gambian children (6 to 27 months). Each child maintained remarkably constant hepcidin levels (P < 0.0001 for between-child variance), with half consistently maintaining levels that indicate physiological blockade of iron absorption. Hepcidin was strongly predicted by nurse-ascribed adverse events with dominant signals from respiratory infections and fevers (all P < 0.0001). Diarrhea and fecal calprotectin were not associated with hepcidin. In multivariate analysis, C-reactive protein was the dominant predictor of hepcidin and contributed to iron blockade even at very low levels. We conclude that even low-grade inflammation, especially associated with respiratory infections, contributes to IDA in African children.

scholarly journals POS0567 HEPCIDIN IS POTENTIAL BIOMARKER TO DISTINGUISH BETWEEN IRON DEFICIENCY ANEMIA AND ANEMIA OF INFLAMMATION IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 518.2-518
Author(s):  
E. Galushko ◽  
A. Semashko ◽  
A. Gordeev ◽  
A. Lila
Keyword(s):  
Rheumatoid Arthritis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Complete Blood Count ◽  
Deficiency Anemia ◽  
Reactive Protein ◽  
Potential Biomarker ◽  
Serum Hepcidin ◽  
Proper Diagnosis ◽  
Anemia Of Inflammation

Background:Anemia of inflammation (AI) and iron deficiency anemia (IDA) are the two most prevalent forms of anemia in patients with rheumatoid arthritis (RA). Diagnosis becomes challenging if AI is associated with true ID (AI/ID), as there is still a lack of a gold standard for differentiation between AI and AI/ID. However, as therapies to overcome anemia differ, proper diagnosis and understanding of underlying pathophysiological regulations are necessary.Objectives:The aim of the study was to evaluate the clinical efficiency of hepcidin, a key regulator of iron metabolism, in the diagnosis of IDA, as well as the differential diagnosis of AI/ID and AI in patients with RA.Methods:The study was undertaken 96 patients with RA, 67 of them were diagnosed anemia according to WHO criteria (104,3±21,4 g/l). Anemic patients and anemia-free patients with RA (n=29) were comparable (p>0.05) in age (44.4±14.8 and 49.8±9.3 years), disease duration (73.5±65.4 and 59.8±48.3 months) and DAS28 (6.3±1.6 and 5.9±1.9). All cases were subjected to following tests: complete blood count with peripheral smear, serum C-reactive protein, serum interleukin-6, iron studies, serum soluble transferrin receptor (sTfR), and serum hepcidin. Patients with RA and anemia were divided two groups: 25 patients with IDA and 42 - with AI. The AI cases were subdivided into pure AI and AI with coexistent ID (n=15).Results:The mean serum hepcidin concentration was significantly increased in pure AI patients (123.85±25.8 ng/mL) as compared to those in IDA patients (63.9±22.8 ng/mL, P < 0.05) and anemia-free patients with RA (88.1±39.09 ng/mL). Also, compared to pure AI patients [normal sTfR levels (<3 µg/mL)], the serum hepcidin concentration was reduced significantly in AI patients with ID [high sTfR levels (≥3 µg/mL)] with a mean of 79.0±23.97 ng/mL.Conclusion:Hepcidin measurement can provide a useful tool for differentiating AI from IDA and also help to identify an iron deficiency in AI patients. This might aid in the appropriate selection of therapy for these patients.Disclosure of Interests:None declared

scholarly journals IRON ABSORPTION AND RESPONSE TO ORAL IRON THERAPY IN IRON DEFICIENCY ANEMIA ASSOCIATED TO ASYMPTOMATIC GIARDIASIS.

1993 ◽  
Vol 33 (6) ◽  
pp. 661-661
Author(s):  
Helena U Suzuki ◽  
Mauro B Morais ◽  
Jose N Corral ◽  
Ulisses Fagundes-Neto ◽  
Nelson L Machado
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Oral Iron ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Oral Iron Therapy

scholarly journals Reply: Intravenous Ferumoxytol in Pediatric Patients With Iron-Deficiency Anemia

2017 ◽  
Vol 51 (12) ◽  
pp. 1146-1146
Author(s):  
Nabil E. Hassan
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Pediatric Patients ◽  
Iron Absorption ◽  
Deficiency Anemia

Iron Deficiency in children is common problem. Its mechanism could be nutritional or due to lack of iron absorption. Several conditions are associated with IDA. Presence of inflammation further complicate attempts to make a definitive diagnoses or accurately quantify reponse to therapy.

Iron Amino Acid Chelates

2004 ◽  
Vol 74 (6) ◽  
pp. 435-443 ◽  
Author(s):  
Hertrampf ◽  
Olivares
Keyword(s):  
Amino Acid ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Ferrous Sulfate ◽  
Iron Absorption ◽  
Iron Status ◽  
Deficiency Anemia ◽  
Efficacy Trials ◽  
Food Matrices ◽  
The Cost

Iron amino acid chelates, such as iron glycinate chelates, have been developed to be used as food fortificants and therapeutic agents in the prevention and treatment of iron deficiency anemia. Ferrous bis-glycine chelate (FeBC), ferric tris-glycine chelate, ferric glycinate, and ferrous bis-glycinate hydrochloride are available commercially. FeBC is the most studied and used form. Iron absorption from FeBC is affected by enhancers and inhibitors of iron absorption, but to a lesser extent than ferrous sulfate. Its absorption is regulated by iron stores. FeBC is better absorbed from milk, wheat, whole maize flour, and precooked corn flour than is ferrous sulfate. Supplementation trials have demonstrated that FeBC is efficacious in treating iron deficiency anemia. Consumption of FeBC-fortified liquid milk, dairy products, wheat rolls, and multi-nutrient beverages is associated with an improvement of iron status. The main limitations to the widespread use of FeBC in national fortification programs are the cost and the potential for promoting organoleptic changes in some food matrices. Additional research is required to establish the bioavailability of FeBC in different food matrices. Other amino acid chelates should also be evaluated. Finally there is an urgent need for more rigorous efficacy trials designed to define the relative merits of amino acid chelates when compared with bioavailable iron salts such as ferrous sulfate and ferrous fumarate and to determine appropriate fortification levels

Intestinal expression of genes involved in iron absorption in humans

2002 ◽  
Vol 282 (4) ◽  
pp. G598-G607 ◽  
Author(s):  
Andreas Rolfs ◽  
Herbert L. Bonkovsky ◽  
James G. Kohlroser ◽  
Kristina McNeal ◽  
Ashish Sharma ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Genetic Disorders ◽  
Hereditary Hemochromatosis ◽  
Transferrin Saturation ◽  
High Serum ◽  
Deficiency Anemia ◽  
Dependent Manner ◽  
Expression Levels

Hereditary hemochromatosis (HHC) is one of the most frequent genetic disorders in humans. In healthy individuals, absorption of iron in the intestine is tightly regulated by cells with the highest iron demand, in particular erythroid precursors. Cloning of intestinal iron transporter proteins provided new insight into mechanisms and regulation of intestinal iron absorption. The aim of this study was to assess whether, in humans, the two transporters are regulated in an iron-dependent manner and whether this regulation is disturbed in HHC. Using quantitative PCR, we measured mRNA expression of divalent cation transporter 1 (DCT1), iron-regulated gene 1 (IREG1), and hephaestin in duodenal biopsy samples of individuals with normal iron levels, iron-deficiency anemia, or iron overload. In controls, we found inverse relationships between the DCT1 splice form containing an iron-responsive element (IRE) and blood hemoglobin, serum transferrin saturation, or ferritin. Subjects with iron-deficiency anemia showed a significant increase in expression of the spliced form, DCT1(IRE) mRNA. Similarly, in subjects homozygous for the C282Y HFE mutation, DCT1(IRE) expression levels remained high despite high serum iron saturation. Furthermore, a significantly increased IREG1 expression was observed. Hephaestin did not exhibit a similar iron-dependent regulation. Our data show that expression levels of human DCT1 mRNA, and to a lesser extent IREG1 mRNA, are regulated in an iron-dependent manner, whereas mRNA of hephaestin is not affected. The lack of appropriate downregulation of apical and basolateral iron transporters in duodenum likely leads to excessive iron absorption in persons with HHC.

scholarly journals Mutation of the gastric hydrogen-potassium ATPase alpha subunit causes iron-deficiency anemia in mice

Blood ◽  
2011 ◽  
Vol 118 (24) ◽  
pp. 6418-6425 ◽  
Author(s):  
Lara Krieg ◽  
Oren Milstein ◽  
Philippe Krebs ◽  
Yu Xia ◽  
Bruce Beutler ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Osmotic Fragility ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Α Subunit ◽  
Hypochromic Microcytic Anemia ◽  
Gastric Proton Pump ◽  
Potassium Atpase

Abstract Iron is an essential component of heme and hemoglobin, and therefore restriction of iron availability directly limits erythropoiesis. In the present study, we report a defect in iron absorption that results in iron-deficiency anemia, as revealed by an N-ethyl-N-nitrosourea–induced mouse phenotype called sublytic. Homozygous sublytic mice develop hypochromic microcytic anemia with reduced osmotic fragility of RBCs. The sublytic phenotype stems from impaired gastrointestinal iron absorption caused by a point mutation of the gastric hydrogen-potassium ATPase α subunit encoded by Atp4a, which results in achlorhydria. The anemia of sublytic homozygotes can be corrected by feeding with a high-iron diet or by parenteral injection of iron dextran; rescue can also be achieved by providing acidified drinking water to sublytic homozygotes. These findings establish the necessity of the gastric proton pump for iron absorption and effective erythropoiesis.

Iron deficiency anemia: A comprehensive review on iron absorption, bioavailability and emerging food fortification approaches

2020 ◽  
Vol 99 ◽  
pp. 58-75 ◽  
Author(s):  
Kumar Shubham ◽  
T. Anukiruthika ◽  
Sayantani Dutta ◽  
A.V. Kashyap ◽  
Jeyan A. Moses ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Deficiency Anemia ◽  
Food Fortification ◽  
Comprehensive Review

scholarly journals Effect of green tea on iron absorption in elderly patients with iron deficiency anemia.

1990 ◽  
Vol 27 (5) ◽  
pp. 555-558 ◽  
Author(s):  
Kazuo Kubota ◽  
Toshio Sakurai ◽  
Kyoumi Nakazato ◽  
Toyoho Morita ◽  
Takuo Shirakura
Keyword(s):  
Iron Deficiency ◽  
Elderly Patients ◽  
Green Tea ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Deficiency Anemia

Pattern of Consultation Referrals for Cytopenia Evaluations to a Hematologist at An Academic Medical Center: The Expanding Role of a Consultant Hematologist

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4673-4673 ◽  
Author(s):  
Thein H Oo
Keyword(s):  
Primary Care ◽  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Iron Deficiency Anemia ◽  
Primary Care Practice ◽  
Academic Medical Center ◽  
Deficiency Anemia ◽  
Care Practice ◽  
Low Grade ◽  
Hematologic Diseases

Abstract Purpose: It appears that many cytopenia consultation referrals to Hematology outpatient clinics turn out to have diseases related to primary care practice. The aim of this retrospective study is to see what proportion and what kind of cytopenia consultations in a Hematology clinic are due to disorders related to primary care practice. Methods: Retrospective chart review analysis of all outpatient referrals from July 2002 to June 2008 to a Hematologist at a tertiary university hospital was performed. Of those, only cytopenia consultations were analyzed. Cases were analyzed according to the presenting cytopenias and the final diagnoses. Results: There were a total of 942 outpatient consultation referrals during this period. 435 consultations were for cytopenia evaluations (46%). Of cytopenia evaluations, the demographics were as follows; male: female = 1: 1.5, age: &lt;60: &gt;60 = 1:1, Caucasian: non-non-Caucasian = 3:1. Distributions of cytopenia consultations were as follows: anemia (60%), thrombocytopenia (15%), leucopenia (10%), pancytopenia (6%), anemia and thrombocytopenia (4%), anemia and leucopenia (2.5%), leucopenia and thrombocytopenia (2.5%). Fortysix cases of cytopenia (11%) resolved on its own without any intervention. Final diagnoses of the rest were iron deficiency anemia 28% (65 cases of gastrointestinal bleeding, 47 cases of menorrhagia, 5 cases due to malabsorption, 5 cases of vegetarianism), myelodysplasia 8%, anemia of multifactorial origin (&gt; more than 1 cause) 7%, anemia due to chronic renal failure only 6%, anemia of chronic disease 2%, drug-induced myelosuppression 6%, ITP 5%, ethnic leucopenia 4%, vitamin B12 deficiency 3%, thalassemia 3%, acute leukemia 2%, myeloma 2%, cirrhosis/hypersplenism 2%, sickle cell/hemoglobinopathy 1.5%, gestational thrombocytopenia 1.5%, viral hepatitis 1%, hereditary spherocytosis 1%, hemolytic anemia 1%, low grade lymphomas 1%, myelofibrosis 1%, non-immune chronic idiopathic neutropenia of adult 1%, immune leucopenia 0.5%, human immunodeficiency virus infection 0.5%, alcoholism 0.5%, paroxysmal nocturnal hemoglobinuria 0.25%. Primary hematologic diseases accounted for 34.25% while the remaining cases were diseases related to primary care practice. Conclusion: Cytopenia consultations accounted for 46% of all referrals. Anemia made up the majority of cytopenia consultations. Iron deficiency anemia due to gastrointestinal bleeding turned out to be the commonest final diagnosis while iron deficiency anemia due to menorrhagia was the second commonest diagnosis. Two-thirds of cytopenia consultations turned out to have diseases related to primary care medicine while primary hematologic diseases accounted for only one-third of the consultations. It appears hematologists are seeing more and more cases of cytopenias due to primary medical diseases (hematologic manifestations of medical diseases) rather than true primary hematologic disorders. Thus, the hematologist’s role as a consultant to primary care practitioners continues to expand.

Sign in / Sign up

Export Citation Format

Share Document